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Health Insurance - Other Types of Health Insurance
Medicare
Medicare is the Federal health insurance program for Americans age
65 and older and for certain disabled Americans. If you are eligible
for Social Security or Railroad Retirement benefits and are age
65, you and your spouse automatically qualify for Medicare.
Medicare has two parts: hospital insurance, known as Part A, and
supplementary medical insurance, known as Part B, which provides
payments for doctors and related services and supplies ordered by
the doctor. If you are eligible for Medicare, Part A is free, but
you must pay a premium for Part B.
Medicare will pay for many of your health care expenses, but not
all of them. In particular, Medicare does not cover most nursing
home care, long-term care services in the home, or prescription
drugs. There are also special rules on when Medicare pays your bills
that apply if you have employer group health insurance coverage
through your own job or the employment of a spouse.
Medicare usually operates on a fee-for-service basis. HMOs and
similar forms of prepaid health care plans are now available to
Medicare enrollees in some locations.
The best source of information on the Medicare program is the Medicare
Handbook. This booklet explains how the Medicare program works and
what your benefits are. To order a free copy, write to: Health Care
Financing Administration, Publications, N1-26-27, 7500 Security
Blvd., Baltimore, MD 21244-1850. You also can contact your local
Social Security office for information.
Some people who are covered by Medicare buy private insurance,
called "Medigap" policies, to pay the medical bills that
Medicare doesn't cover. Some Medigap policies cover Medicare's deductibles;
most pay the coinsurance amount. Some also pay for health services
not covered by Medicare. There are 10 standard plans from which
you can choose. (Some States may have fewer than 10.) If you buy
a Medigap policy, make sure you do not purchase more than one.
You need to shop carefully before deciding on the best policy to
fit your needs. You may get another booklet, Guide to Health Insurance
for People with Medicare, to help you in making the right choice.
To order a free copy, write to: Health Care Financing Administration,
Publications, N1-26-27, 7500 Security Blvd., Baltimore, MD 21244-1850.
Another good source of information on the same topic is The Consumer's
Guide to Medicare Supplement Insurance. To order a free copy, write
to: Health Insurance Association of America, 555 13th St., N.W.,
Suite 600 East, Washington, D.C. 20004.
Medicaid
Medicaid provides health care coverage for some low-income people
who cannot afford it. This includes people who are eligible because
they are aged, blind, or disabled or certain people in families
with dependent children. Medicaid is a Federal program that is operated
by the States, and each State decides who is eligible and the scope
of health services offered.
General information on the Medicaid program is given in the Medicaid
Fact Sheet. For a free copy, write to: Health Care Financing Administration,
Publications, N1-26-27, 7500 Security Blvd., Baltimore, MD 21244-1850.
For specifics on Medicaid eligibility and the health services offered,
contact your State Medicaid Program Office.
Disability Insurance
Disability insurance replaces income you lose if you have a long-term
illness or injury and cannot work. This is an important type of
coverage for working-age people to consider. Disability insurance
does not cover the cost of rehabilitation if you are injured. Check
your major medical insurance to see if it is covered there.
Some employers offer group disability insurance and this may be
one of the benefits where you work. Or you might be eligible for
some government-sponsored programs that provide disability benefits.
Many different kinds of individual policies are also available.
The Consumer's Guide to Disability Insurance explains disability
insurance and sources of disability income to help you decide if
you need this coverage. It will also help you compare your choices
of policies. For a free copy, write to: Health Insurance Association
of America, 555 13th St., N.W., Suite 600 East, Washington, D.C.
20004.
Hospital Indemnity Insurance
This insurance offers limited coverage. It pays a fixed amount for
each day, up to a maximum number of days. You may use it for medical
or other expenses. Usually, the amount you receive will be less
than the cost of a hospital stay.
Some hospital indemnity policies will pay the specified daily amount
even if you have other health insurance. Others may coordinate benefits,
so that the money you receive does not equal more than 100 percent
of the hospital bill.
Long-Term Care Insurance
Long-term care insurance is designed to cover the costs of nursing
home care, which can be several thousand dollars each month. Long-term
care is usually not covered by health insurance except in a very
limited way. Medicare covers very few long-term care expenses. There
are many plans and they vary in costs and services covered, each
with its own limits.
More detailed information is given in A Shopper's Guide to Long-Term
Care Insurance. Contact your State Insurance Department or write:
National Association of Insurance Commissioners, 120 W. 12th Street,
Suite 1100, Kansas City, MO 64105.
Another good source of information is The Consumer's Guide to Long-Term
Care Insurance. For a free copy, write to: Health Insurance Association
of America, 555 13th St., N.W., Suite 600 East, Washington, D.C.
20004.
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